Zach Wilson, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

038012081 Issued in IL

Practice address

700 Highland Ave
Fort Atkinson, WI 53538-2749

Phone

(920) 542-1028

Fax

(920) 542-1027

NPI assigned

Dec 19, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1861761066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 DEAN ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341600",
            "telephone_number": "309-678-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGHLAND AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535382749",
            "telephone_number": "920-542-1028",
            "fax_number": "920-542-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ZACH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-19",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038012081",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4867-12",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Paul Wilde, PT
• Trisha Williams Obiweluozor, RN
• Wilson Chiropractic & Wellness LLC
• Brett Wilson, DO
• Stephanie Tronnes Wilson, D.C.
• Jennifer Ann Winter, MD
• Ernest Theodore Witzke, B.S., M.S.
• Wade W Woelfle, M.D.
• Tina M Yoss I, APNP
• Michael Todd Zagelow, RPH

• Sports Physician Chiropractor in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Sports Physician Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.